Provider Demographics
NPI:1619068871
Name:BAUMANN, JAROL LYN (PT)
Entity Type:Individual
Prefix:
First Name:JAROL
Middle Name:LYN
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 OLD SHEPARD PL
Mailing Address - Street 2:STE 202
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5292
Mailing Address - Country:US
Mailing Address - Phone:214-556-8905
Mailing Address - Fax:214-556-8908
Practice Address - Street 1:4601 OLD SHEPARD PL
Practice Address - Street 2:STE 202
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5292
Practice Address - Country:US
Practice Address - Phone:214-556-8905
Practice Address - Fax:214-556-8908
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1085686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81574TOtherBLUE CROSS BLUE SHIELD
TX382617193Medicare UPIN
TX456775Medicare ID - Type Unspecified